PLoS ONE (Jan 2023)

HIV-1 subtype diversity and immuno-virological outcomes among adolescents failing antiretroviral therapy in Cameroon: A cohort study.

  • Willy Le Roi Togna Pabo,
  • Joseph Fokam,
  • Debimeh Njume,
  • Désiré Takou,
  • Maria-Mercedes Santoro,
  • Raymond Babila Nyasa,
  • Collins Chenwi,
  • Marie Laure Mpouel,
  • Grace Beloumou,
  • Ezechiel Semengue Ngoufack Jagni,
  • Alex Durand Nka,
  • Aude Christelle Ka'e,
  • Georges Teto,
  • Beatrice Dambaya,
  • Sandrine Djupsa,
  • Davy Hyacinthe Gouissi Anguechia,
  • Molimbou Evariste,
  • Cedric Kamta,
  • Lionel Bala,
  • Virginie Lambo,
  • Edie Gregory Halle-Ekane,
  • Vittorio Colizzi,
  • Carlo Federico Perno,
  • Alexis Ndjolo,
  • Roland Ndip Ndip

DOI
https://doi.org/10.1371/journal.pone.0293326
Journal volume & issue
Vol. 18, no. 10
p. e0293326

Abstract

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ObjectiveWe sought to evaluate the variability of HIV-1 and its effect on immuno-virological response among adolescents living with perinatally acquired HIV (APHI).MethodsA cohort study was conducted from 2018-2020 among 311 APHI receiving antiretroviral therapy (ART) in Cameroon. Sequencing of protease and reverse transcriptase regions was performed for participants experiencing virological failure, VF, (Plasma viral load, PVL ≥ 1000 RNA copies/ml). HIV-1 subtypes were inferred by phylogeny; immuno-virological responses were monitored at 3-time points (T1-T3). Cox regression modeling was used to estimate adjusted hazard ratios (aHRs) of progression to: CD4 5log10, adjusted for acquired drug resistance, gender, ART line, adherence, and duration on treatment; p ResultsOf the 141 participants in VF enrolled, the male-female ratio was 1:1; mean age was 15 (±3) years; and median [IQR] duration on ART was 51 [46-60] months. In all phases, 17 viral clades were found with a predominant CRF02_AG (58.2%, 59.4%, and 58.3%). From T1-T3 respectively, there was an increasing CD4 count (213 [154-313], 366 [309-469], and 438 [364-569] cells/mm3) and decline log10 PVL (5.23, 4.43, and 4.43), similar across subtypes. Among participants with CRF02_AG infection, duration of treatment was significantly associated with both rates of progression to CD4 5log10, aHR = 0.02 (0.001-0.52), and aHR = 0.05 (0.01-0.47) respectively. Moreover, four potential new HIV-1 recombinants were identified (CRF02_AG/02D, CRF02_AG/02A1F2, D/CRF02_AG, and AF2/CRF02_AG), indicating a wide viral diversity.ConclusionAmong APHI in settings like Cameroon, there is a wide genetic diversity of HIV-1, driven by CRF02_AG and with potential novel clades due to ongoing recombination events. Duration of treatment significantly reduces the risk of disease progression.